When we first began the Forward Promise initiative, we envisioned building the capacity and impact of organizations across the country working with boys and young men of color from every type of community and background. We wanted to identify and support a cohort of grantees that were diverse in their approach, in their geography, and in the racial, ethnic and cultural experiences of the young people that they supported. Once we began doing this work, it didn’t take long to realize we were falling short.

The simple truth is that the majority of organizations who applied for Forward Promise that had demonstrated success and were ready to expand were located in major cities. Few applicants were in the rural beltway that stretches across the Southern United States, from Alabama to Arizona. It would be easy to assume that there weren’t many young men of color there or that there was not much innovation or capacity to support young men of color in that region. But you know what they say about assumptions ...

Alexia Green, RN, PhD, FAAN, professor and dean emeritus, Texas Tech University Health Sciences Center and co-leader of the Texas Action Coalition. She is an alumna of the Robert Wood Johnson Foundation Executive Nurse Fellows program.

As a nurse, I have long desired to be a full partner with physicians and other health care leaders in improving health care delivery in our country. The truth is many nurses have this desire, but all too often we are not viewed as key players in the larger policy arena. When the Institute of Medicine Future of Nursing report was issued in 2010, I was very excited to see a major emphasis placed on nurses become full partners in redesigning health care in the United States.

I personally became intrigued with impacting health care policy while a graduate student at the University of Texas Health Sciences Center in Houston—where my professor, Dorothy Otto, encouraged me to become engaged, providing me with a vision that policy was something I could shape and develop rather than passively watch. My engagement with the Texas Nurses Association and the Robert Wood Johnson Foundation Executive Nurse Fellows program helped solidify my leadership skills to be well prepared to actively serve on boards where policy decisions are made in hopes of improving health systems to advance patient care.

Three years ago this week, the Institute of Medicine issued a landmark report, Future of Nursing: Leading Change, Advancing Health. Its recommendations include increasing the proportion of nurses with baccalaureate degrees to 80 percent by 2020. Cole Edmonson, DNP, RN, FACHE, NEA-BC, is chief nursing officer at Texas Health Presbyterian Hospital Dallas, and a Robert Wood Johnson Foundation Executive Nurse Fellow (2012 – 2015). He also serves as practice team co-lead for the Texas Team, the state’s Action Coalition.

Improving the lives of people in the communities we serve is our guiding mission and it is supported by our Magnet Redesignation program and our professional practice model. In 2010, when the Institute of Medicine’s (IOM) Future of Nursing report was released, we were one of the few IOM meeting sites in Texas to bring together people from both practice and academia to hear about the report and begin to discuss how we might fulfill the 2020 vision with the creation of new partnerships.

The IOM report was a call to action, to which we responded. Texas Health Presbyterian Hospital Dallas, a part of Texas Health Resources, began the journey by exposing leadership and direct care staff to the report, the research (compelling reasons) behind it, its recommendations, and the gap analysis of the organization in the eight areas of recommendations.

The nursing leadership, with the direct care nurses and the system leadership, integrated the Future of Nursing report into our nursing strategic plan in 2011. The strategies and tactic with metrics of success set in motion a series of actions to meet the 80 percent bachelor of science in nursing (BSN) goal by 2020, doubling the nurses with doctorates, Advanced Practice Registered Nurse (APRN) practice scope, and positioning nurses in strategic positions including the Board of Trustees.

CPR training kiosk, part of an American Heart Association pilot project

Passengers at the Dallas Fort Worth Airport in Texas can now go from “killing time” to “savings lives” while they wait for their flights.

Since last month, a new, innovative kiosk not much bigger than an ATM machine and installed at the American Airlines terminal, lets travelers stop and learn the basics of CPR in just minutes using a chest model and an audio instructor. The CPR pilot project, which will be tested for six months, is a joint effort of the American Heart Association (AHA) and American Airlines, part of a plan by the AHA to train millions more lay people to perform CPR, and potentially saves tens of thousands of lives.

Now, a few minutes at the kiosk won’t get most bystanders up to the level of paramedics, but “any chest compression is better than none and can increase survival,” says Ahamed Idris, MD, a spokesman for the AHA and professor of Surgery and Internal Medicine at the University of Texas Southwestern Medical Center in Dallas. Dr. Idris helped develop the kiosk.

According to AHA, about 360,000 U.S. adults suffer cardiac arrest outside of hospitals each year, but only about 10 percent survive. Vastly increasing the number of citizens who can call for help and then start CPR on a victim could more than double that survival rate, says Dr. Idris.

Lisa Campbell, DNP, RN, APHN-BC, is an associate professor at Texas Tech University Health Sciences Center, and director of Population Health Consultants, LLC in Victoria, Texas—a company that works to build human capital to improve population health. She serves as newsletter co-editor for the American Public Health Association, Public Health Nursing Section.

With 36 percent of the public health nursing workforce reporting age 56 or older, according to the new report from the Robert Wood Johnson Foundation, strategic planning by state and local health departments must include creative strategies to recruit. In order to increase the numbers of nurses in public health, hiring practices will require a paradigm shift. Public health nurses new to the field bring a unique perspective that will assist in bridging the gap between public and private partnerships. Furthermore, public health is charged with adaptive practice innovations to implement programs outlined in the Affordable Care Act. To illustrate this point, I would like to share my public health nursing journey.

I decided to become a public health nurse after being a nurse practitioner for more than 25 years. When I embarked on this journey, I had no idea where it would take me.

What can happen when local partners collaborate to improve community health? In Austin, Texas, one such collaboration between the local YMCA, child safety advocacy group SafeKids Austin, Dell Children’s Medical Center of Central Texas and local elementary schools, has resulted in Project SAFE (Swimming, Aquatics, Fitness Education). The project, a free, two-week water safety and physical activity program for over 3,000 first-graders, includes an introduction to the Y, and its sliding scale fees for the kids and their families, many of whom are from underserved neighborhoods. About 20 percent of the families of kids in the project program returned to the Y facilities after their kids completed the class.We took a detour while in Austin for the ASTHO Annual Meeting to learn more about the Austin YMCA’s programs.

Not all the kids are swimmers by the end of the sessions, but most are comfortable in the water, can float on their back, know the importance of life jackets, recognize a swimmer in trouble and know “it’s not safe to run at the pool,” chime a group that has just finished up a morning lesson. That knowledge can be lifesaving, says Bret Kiester, executive director of the Hays Communities YMCA, one of the participating Y’s hosting the classes.

“Drowning is the leading cause of death in the U.S. for kids under fourteen, and many of these kids have no regular access to pools or the beach,” Kiester. On vacation, Kiester says, families may visit lakes, rivers and pools—and having no familiarity with water is often how accidents happen.

The Robert Wood Johnson Foundation’s Academic Progression in Nursing (APIN) program this week announced that California, Hawaii, Massachusetts, Montana, New Mexico, New York, North Carolina, Texas and Washington state have been chosen to receive grants to advance state and regional strategies aimed at creating a more highly educated, diverse nursing workforce. Each state will receive a two-year, $300,000 grant.

The states will now work with academic institutions and employers on implementing sophisticated strategies to help nurses get higher degrees in order to improve patient care and help fill faculty and advanced practice nursing roles. In particular, the states will encourage strong partnerships between community colleges and universities to make it easier for nurses to transition to higher degrees.

In its groundbreaking report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine (IOM) recommended that 80 percent of the nursing workforce be prepared at the baccalaureate level or higher by the year 2020. At present, about half of nurses in the United States have baccalaureate or higher degrees.

Creating and sustaining partnerships is vital to the Texas Team: Advancing Health through Nursing—a state Action Coalition of the Future of Nursing: Campaign for Action. Although the Texas Team was only approved as an official Action Coalition in September 2011, we have been working diligently to recruit and build partners who can support the campaign through 2020.

The various state Action Coalitions—such as the Texas Team—are composed of multiple entities (mostly other organizations), which in turn are composed of multiple individuals. Engaging and maintaining interest and commitment from these multiple entities is a very real challenge for the Texas Team and other newly formed Action Coalitions, but it is vital to all our success in achieving our Institute of Medicine (IOM) goals in our respective states. As leaders we must strive to engage all these partners and promote a common vision toward achieving the IOM goals.

Key to our success in Texas has been the recruitment of BlueCross BlueShield of Texas as our lead business organization for the statewide team. BlueCross BlueShield partners with the Texas Nurses Association as our lead nursing organization to advance the health of Texans through our Coalition activities. The Texas Hospital Association was an early partner and has also been very supportive of our activities.

Other diverse partners that have joined our Coalition include Bell Helicopter. Yes, that’s right, the folks who make helicopters! (And no, they haven’t provided us with any rides yet!) But they are very committed to advancing the health of our state through nursing. Associates in Process Improvement, a group of improvement scientists (yes, those same scientists who work with the Institute for Healthcare Improvement) have also joined us because they too deem nurses integral to the improvement of health care across our nation.